AB1278 ANALYSIS OF THE DIFFERENCES BETWEEN TUBERCULOSIS PROPHYLAXIS REGIMENS IN BIOLOGIC CANDIDATE PATIENTS
Authors: L. Mendez Diaz, R. J. Gil Velez
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Patients with systemic rheumatic disease present alterations in the regulation of the immune system, which may contribute to the reactivation of latent tuberculosis. That risk increases significantly in patients receiving biological treatment (approximately 10%, especially with infliximab). The detection and treatment of latent tuberculosis infection constitutes a fundamental pillar to prevent the evolution of the pathology in patients receiving biological therapy protocolized in the US in the year 2000 by the FDA. Multiple studies have shown that diagnosis and treatment of latent tuberculosis infection is the best method of preventing progression to active tuberculosis. To prevent that condition que have two types of treatment schemes: -The short chemoprophylaxis regimen,consisting of the administration of isoniazid together with rifampicin for 3 months -The long chemoprophylaxis regimen consisting of the administration of isoniazid for a period of 6 months without interruption. <h3>Objectives</h3> To analyze the efficacy,safety and to difference the treatment adherence between the two regimens of chemoprophylaxis in patients who are candidates to start biologic therapy with latent tuberculosis. <h3>Methods</h3> Retrospective descriptive study of a cohort of patients who start biological therapy between (January-December 2021), in the Rheumatology Service of Virgen del Rocio Hospital. Latent tuberculosis screening protocol was performed by Mantoux/Booster and IGRA tests. <h3>Results</h3> We included a total of 223 patients in the study who started treatment with biological therapy, during a period of 12 months, 125 (58,13%) of those where men, 90 patients (41,8%) were women with a mean age of 51.4 years. We started chemoprophylaxis in 32 patients, of whom 15 (46.8%) received short therapy with isoniazid/rifampicin daily for 3 months, only 1 patient he had to discontinue treatment due to hepatotoxicity. The rest of the patients 17 (53.2%) underwent long therapy for 6 months with isoniazid 300 mg every 24 hours, completing it in 94.2% of the cases. Only one patient had to discontinue due to persistent nausea. <h3>Conclusion</h3> After analyzing the data of our cohort of patients candidates to start biological therapy and after having performed the screening for latent tuberculosis infection(as can be seen in the Table 1 below) a homogeneous group (46.8% in the case of short regime) and (53.2% in the case of long regime) were treated with chemoprophylaxis, without significant differences in terms of adverse effects or adherence in the two therapies performed. The most common cause of discontinuation in both groups was hypertrasaminasaemia and nausea. No tuberculosis reactivation has occurred in any of the groups. Therefore, we conclude that short term therapy is as safe as long therapy and with similar patient adherence. However, long-term studies with a larger number of patients are required to evaluate the two treatment regimens. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.